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- Sep 27, 2006
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Patient shows up for 14th baby, 5th c-section, known previa. She's in labor, surgeon wants to go for c-section ASAP.
She's gotten blood before, so she has a variety of antibodies (not anti-d, we're talking Lewis, Kell, Kidd, etc.) Blood bank tells me it will be hours before they can match her to acceptable PRBC units.
Yeah, yeah, I know, I agree with you, I wish she had had the tubes tied ten babies ago, but she's here now, and very very likely to bleed/have an accreta. I plan to do it under general (I have good IV access, I placed an a-line, airway is not a problem, the only controversy here is with the blood)
If I had my way, we would have seen her last week in preop and arranged to have blood available, but she's just shown up now for the first time at this hospital.
What would you do if you have to go before the blood bank can provide you with acceptable blood? Now we have late decels, can we proceed knowing we'll have to give her type matched but uncrossed blood in a pt with antibodies?
She's gotten blood before, so she has a variety of antibodies (not anti-d, we're talking Lewis, Kell, Kidd, etc.) Blood bank tells me it will be hours before they can match her to acceptable PRBC units.
Yeah, yeah, I know, I agree with you, I wish she had had the tubes tied ten babies ago, but she's here now, and very very likely to bleed/have an accreta. I plan to do it under general (I have good IV access, I placed an a-line, airway is not a problem, the only controversy here is with the blood)
If I had my way, we would have seen her last week in preop and arranged to have blood available, but she's just shown up now for the first time at this hospital.
What would you do if you have to go before the blood bank can provide you with acceptable blood? Now we have late decels, can we proceed knowing we'll have to give her type matched but uncrossed blood in a pt with antibodies?